Open letter to the CDC

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On 17 January 2015, an anonymous physician who created the Facebook page The Activist MD, wrote an open letter to the CDC which reads:

Here's my letter to the CDC regarding their pro-circ stance. May they hear the voices of reason and realize that circumcision should in no way be considered appropriate preventive health care.

Open letter to the CDC
As an American physician, I am extremely disappointed in these recommendations. My most important job as a physician is to protect the health and well-being of my community. Circumcision is a dangerous, detrimental procedure that must end in our country, just as it has been shunned by other medically-advanced countries.

This statement considers the very modest potential medical benefit, while ignoring other important considerations. First of all, condoms and other safe sex practices will always be more effective and important than circumcision for prevention of sexually transmitted diseases and our efforts should be focused accordingly. To give one a false sense of security that circumcision fully prevents STIs/HIV would be a true disservice. We must also carefully interpret data regarding the circumcision for the prevention of any STI, as many studies have failed to show this correlation (PubMedID: 23710368[1], 18280846[2], 18043319[3], 22320006[4]).

Circumcision is undeniably painful, to the degree that it appears to influence pain perception in the long-term (PMID: 15495086[5], 9057731[6]). Complications from circumcision range from mild to fatal. I personally have seen several boys have problems with major bleeding after circumcision, and know of others that have had problems with infection, scarring, and additional damage to the penis. Other complications such as meatal stenosis are under-recognized (PMID: 20851685[7]). Circumcision also has long-term negative sexual effects on both male and female partners, which must be acknowledged (PMID: 21672947[8], 10349418[9], 14581975[10]). These complications have important physical, emotional, and financial costs and should not be trivialized. Unfortunately, a comprehensive discussion of these risks is not typically included during the informed consent process.

Finally, I am appalled that a reputable medical organization would condone the forced alteration of a child's genitals, especially since girls have been appropriately been legally protected from this for many years now. Deciding how one's genitals appear and function is one of the most intimate decisions possible. I know literally hundreds of men who resent being circumcised, many of which are plagued by chronic problems from their circumcision. The only person to choose circumcision or any other cosmetic procedure should be the owner of that body. Physicians have no business performing painful, unnecessary procedures on non-consenting patients.
The Activist MD (Facebook)[11]

See also

References

  1. REFjournal Van Howe RS. Sexually transmitted infections and male circumcision: a systematic review and meta-analysis. ISRN Urol. 16 April 2013; PMID. PMC. DOI. Retrieved 26 September 2021.
  2. REFjournal Dickson NP, van Roode T, Herbison P, Paul C. Circumcision and risk of sexually transmitted infections in a birth cohort. J Pediatr. March 2008; 152(3): 383-7. PMID. DOI. Retrieved 26 September 2021.
  3. REFjournal Millett GA, Ding H, Lauby J, Flores S, Stueve A, Bingham T, Carballo-Dieguez A, Murrill C, Liu KH, et al. Circumcision status and HIV infection among Black and Latino men who have sex with men in 3 US cities. J Acquir Immune Defic Syndr. 15 December 2007; 46(5): 643-50. PMID. DOI. Retrieved 26 September 2021.
  4. REFjournal Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns PDF. Thompson Reuter. December 2011; 19(2): 316-34. PMID. Retrieved 30 December 2020.
  5. REFjournal Brady-Fryer B, N Wiebe N, Lander JA. Pain relief for neonatal circumcision. Cochrane Database Syst Rev. 18 October 2004; (4): CD004217. PMID. DOI. Retrieved 26 September 2021.
  6. REFjournal Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1 March 1997; 349: 599-603. PMC. DOI. Retrieved 15 November 2022.
  7. REFjournal Joudi M, Fathi M, Hiradfar M. Incidence of asymptomatic meatal stenosis in children following neonatal circumcision. J Pediatr Urol. October 2011; 7(5): 526-8. PMID. DOI. Retrieved 26 September 2021.
  8. REFjournal Frisch M, Lindholm M, Grønbæk M. Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. Int J Epidemiol. 14 June 2011; 40(5): 1367-81. PMID. DOI. Retrieved 26 September 2021.
  9. REFjournal O'Hara K, O'Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int. January 1999; 83 Suppl 1: 79-84. PMID. DOI. Retrieved 26 September 2021.
  10. REFjournal Bensley GA, Boyle GJ. Effects of male circumcision on female arousal and orgasm. N Z Med J. 12 September 2003; 116(1181): U595. PMID. Retrieved 26 September 2021.
  11. REFweb (17 January 2015). Open letter to the CDC: Letter to the CDC. Retrieved 26 September 2021.

Circumcision debate‏‎